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I'm James Maxey, the author of the Dragon Age fantasy series of Bitterwood, Dragonforge, and Dragonseed, the Dragon Apocalypse series of Greatshadow, Hush, and Witchbreaker, as well as the superhero novels Nobody Gets the Girl and Burn Baby Burn. I use this site to discuss a wide range of topics, with a heavy emphasis on cranky, uninformed rants about politics and religion and other topics that polite people attempt to avoid. For anyone just wanting to read about my books, I maintain a second blog, The Prophet and the Dragon, where I keep the focus solely on my fiction. I also have a webpage where both blogs stream, with more information about all my books, at jamesmaxey.net.

Saturday, March 24, 2007

Our Health Care System Makes Me Sick

I have very complicated feelings about the American health care system. I was talking to a friend of mine this week who's been buying health insurance through a COBRA plan that's about to expire. He's willing to purchase his own insurance... except he has diabetes and the cheapest plan he's been quoted--a bare bones, catastrophic plan--is $2000 a month. How many people can afford $24,000 a year for an insurance plan that barely covers anything? And, at least he can get insurance. If he had stage 4 cancer, he wouldn't be able to buy a plan.

I am, at heart, a free market libertarian who opposes government intervention. Toward the end of Laura's life, she was dealing more and more with the government and every single encounter was Kafkaesque. Agencies that were supposed to be geared toward assisting her were consistently staffed by people who seemed indifferent, incompetent, and downright hostile. The thought of the government taking over our health care system leaves me with a heavy lump in my gut. I honestly think they would turn our system into a beaurocratic nightmare.

And yet, as my friend Greg would be quick to point out, has the private system done any better? I recently spent several months dealing with Labcorp, disputing a charge for a test I'd had the previous year. I'd had some tests in December of 2005, gotten some bills in January 2006, paid them, and that was that. At least, that was that until August, when I got a bill for $150 from Labcorp. I called them immediately, wondering what this was, but on that initial call I never got to speak to a human being. They had an automated system, and any sequence of buttons I followed wound up taking me to an answering machine. So, I left my phone # and told them to call me. A week later, with no return calls, I forgot about it. I figured somebody had taken a look at the bill, realized, "Oops, he's already paid this," and moved on. I am an eternal optimist. Of course, a month later, I get another bill. This time I write a letter questioning the validity of the charges and send it back. Then, helpfully, a week later somebody calls and tells me that this charge for $150 was disallowed by my insurance because I hadn't met my deductable and I still owe the full amount. I was, bluntly, skeptical. These were for tests in December... I'm not a heavy user of healthcare, but I was pretty sure my deductable had been met. And, I asked why they had waited to August to bill me for the test. The representative told me that the insurance company could sometimes take a month or two to respond to the claims. I told her that the insurance company had responded to everything in January, and I'd paid anything left over. What had happened between January and August? She again said it took a month or two for decisions to be made. I pointed out that, a month or two would be a bill in February or March. She never did concede that August was anything but a month or two after December.

I told her I would check with my insurance and call her back. Blue Cross Blue Shield proved to be quite helpful. One phone call and I had the information I needed... they hadn't paid this bill, but they had negotiated a new charge... $19.95 instead of $150. They offered to mail me a copy of the paperwork. I said okay, then called back Labcorp. I spoke to someone new this time. I had the name of the rep I'd spoken to earlier, but was told by the new person I spoke to that she knew of no such person and that there was no record of me having ever contacted Labcorp about my past due bill. She told me that the $19.95 was only a rate for people who had insurance. When I pointed out that I did, indeed, have insurance, it seemed to throw her off her game. She said she'd have to call me back.

Then, another month passed and a bill collector for Labcorp called, telling me my credit card had been declined and they were about to pursue legal action for the $150. I was utterly baffled by the credit card claim, since I had no memory of ever giving them a number. (Though, it turned out I had given the doctor who ordered the test a credit card #, and they'd attempted to bill it. Why it was declined, I don't know. The number I eventually saw on the paperwork was perfectly valid. A little too valid, as my monthly statements will attest.) I was also frustrated to again be starting at ground zero, talking to someone at Labcorp who wouldn't admit that I'd ever contacted them before.

Then... well, it occurs to me that this is a long and tedious story. The whole point of the story is what a long and tedious process it was to handle a bill for this one stupid test. But I don't see why I should punish my readers with every blow by blow detail. Let's just say that a lot of faxes were sent back and forth and I eventually found a supervisor at Labcorp who had a name and extension # and I was able to harrass her until they finally sent me a bill for the correct amount.

In January, everything was, finally (I hope) resolved with me sending them a check for $19.95. I suppose it will be August before I really know if this has been taken care of.

Anyway, my point was that the beaurocratic nightmare I fear would befall us if the government took over health care is already here now that corporations run our health care. Mortality statistics tell us that people die of heart disease and cancer and trauma... but I wonder just how many people actually pass away just to avoid the paperwork.

The thing that's got me thinking about this was the news that John Edward's wife has stage 4 cancer. Her diagnosis is almost identical to Laura's after her time of being cancer free. I have an x-ray of Laura's torso with the tiny black tumors circled; I imagine Ms. Edward's x-ray looks pretty much the same. It gives me a personal connection to this story; I've always wondered if Laura had lived another five years if they would have found a cure. Ms. Edwards probably has those five years, so I guess I'll find out. I also always wondered if Laura would have gotten a different level of treatment if she'd been wealthy. I've noticed that there are an awful lot of Supreme Court judges who get cancer and survive it for many, many years. John Edward's is filthy rich, a hell of a lot richer, probably, than any of the Supreme Court justices. And yet, here's my second personal connection to the story: Ms. Edwards has the same oncologist that Laura had, Dr. Lisa Carrey. So, the former senator's wife is getting the same doctor treating her as the former preschool teacher. Maybe money isn't dividing up the treatment as unequally as I thought.

I wish I had some potential solution to offer to the mess that health care has become. Government intervention seems like a path to disaster. On the other hand, the status quo seems to be that you can get decent healthcare as long as your employer is paying for your insurance, until you get too sick to work, at which point you lose your insurance at the time of your life where you actually most need it. On the other, other hand, as horrible as our system is, and as wonderful as a Canada and England and Italy's system is (according to my liberal friends who want the government to take over healthcare), I presume that, with the Edwards' wealth, if better treatment for cancer was available in Canada, they'd be seeking treatment in Canada.

If a cure for cancer emerges, it's probably going to emerge from the horrible, screwed up, unaffordable American system.

Rick, you've summed it up perfectly. I think that people who say we have the best health care in the world have a lot of evidence to back them up. And, people who say that our system is Kafkaesque, expensive, and unfair are also right. Figuring out how to fix the bad without wrecking the good is the problem in a nutshell.

James Maxey

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The Dragon and the Prophet

While this blog covers a wide range of topics, I have a second blog called The Prophet and the Dragon devoted to news and information about my books, especially my current series of novels set in the Dragon Age.